Long‐term implant survival and success: a 10–16‐year follow‐up of non‐submerged dental implants

Objectives: The aim of the present study was to evaluate the long‐term results of dental implants using implant survival and implant success as outcome variables. Methods: Of the 76 patients who received 162 implants of the Straumann Dental Implant System during the years 1990–1997, 55 patients with 131 implants were recalled 10–16 years after implant placement for a complete clinical and radiographic examination, followed by a questionnaire that examined the degree of satisfaction. The incidence of biological and technical complications has been carefully analysed for each implant. Success was defined as being free of all these complications over the entire observation period. Associated factors related to peri‐implant lesions were analysed for each implant. Results: The long‐term implant cumulative survival rate up to 16 years was 82.94%. The prevalence of biological complications was 16.94% and the prevalence of technical complications was 31.09%. The cumulative complication rate after an observation period of 10–16 years was 48.03%, which meant that substantial amounts of chair time were necessary following implant placement. The majority of implant losses and biological complications were concentrated in a relatively small number of patients. Conclusion: Despite a relatively high long‐term survival rate, biological and technical complications were frequent. Patients with a history of periodontitis may have lower implant survival rates than patients without a history of periodontitis and were more prone to biological complications such as peri‐implant mucositis and peri‐implantitis. To cite this article :
Simonis P, Dufour T, Tenenbaum H. Long‐term implant survival and success: a 10–16‐year follow‐up of non‐submerged dental implants.
Clin. Oral Impl. Res. 21 , 2010; 772–777
doi: 10.1111/j.1600‐0501.2010.01912.x     

Fixed Implant‐Retained Rehabilitation of the Edentulous Maxilla: 11‐Year Results of a Prospective Study

Objectives: The aim of the present study was to assess long‐term survival and success rates of implants in the edentulous maxilla restored with an implant‐supported fixed prosthesis. Materials and Methods: Seventeen edentulous patients received six to eight implants and implant‐supported fixed prostheses by one surgeon. Yearly recalls were conducted by two examiners over a period of 11 years. Survival and success rates (biological complications) were determined; marginal bone loss was examined radiographically. Furthermore, microbiological tests as well as test for interleukin‐1 composite genotype were assessed and potential risk factors were evaluated. Results: After a mean time of 11.26 years, 15 patients of 17 could be reexamined. Out of 94 implants, three were lost in one patient. Mean marginal bone loss reached 0.88 mm, two patients (at seven implants) showed bone loss of ≥3.2 mm. Survival rate of implants reached 96.8%. Success rates on implant level hit 92.6% according to the criteria of Albrektsson and colleagues and 83.0% in accordance with Karoussis and colleagues. One prosthesis had to be renewed. Conclusion: Within the limitation of this study, restoration of the edentulous maxilla with an implant‐supported fixed prosthesis represents an effective tool for rehabilitation over a period of 11 years.     

Maxillary implant‐supported overdentures opposed by (partial) natural dentitions: a 5‐year prospective case series study

The aim of this study was to assess the 5‐year treatment outcome of maxillary implant‐retained overdentures opposed by natural antagonistic teeth. Fifty consecutive patients received maxillary overdentures supported by six dental implants. Implants were placed in the anterior region, if enough bone was present (n = 25 patients) Implant were placed in the posterior region if implant placement in the anterior region was not possible (n = 25 patients). Variables assessed included survival of implants, condition of hard and soft peri‐implant tissues and patients' satisfaction. The five‐year implant survival rate was 97·0% and 99·3%, and mean radiographic bone loss was 0·23 and 0·69 mm in the anterior and posterior group, respectively. Median scores for plaque, calculus, gingiva, bleeding and mean scores for pocket probing depth were low and stayed low. Patients' satisfaction after treatment was high in both groups. Within the limits of this 5‐year study, it is concluded that six dental implants (placed in the anterior or posterior region) connected with a bar and opposed to natural antagonistic teeth result in acceptable results for clinical parameters and good outcomes for marginal bone level changes and patient satisfaction.     

Narrow‐ and regular‐diameter implants in the posterior region of the jaws to support single crowns: A 3‐year split‐mouth randomized clinical trial

Objectives

The objective of this 3‐year split‐mouth randomized controlled clinical study was to compare narrow‐diameter implants (NDIs) to regular‐diameter implants (RDIs) in the posterior region of the jaws (premolars and molars) in regards to (i) the marginal bone level (MBL) and (ii) implant and prosthesis survival and success rates.

Material and Methods

A total of 22 patients were included in the study. Each patient received at least one implant of each diameter (Ø3.3 and Ø4.1 mm), placed either in the maxilla or mandible to support single crowns. A total 44 implants (22 NDIs and 22 RDIs) were placed and included in the study. Twenty‐one implants were placed in the premolar, whereas 23 were placed in molar areas. Radiographic evaluations to access the MBL were performed immediately after implant placement, 1 and 3 years after implant loading. Peri‐implant clinical variables including probing pocket depth (PPD) and bleeding on probing (BoP) were obtained after crown delivery, 1 and 3 years after loading. Furthermore, the survival and success rates of the implants and prosthesis were also evaluated.

Results

Twenty patients were able to complete the study. There was no statistically significant difference regarding MBL between groups at implant placement (p = .084), 1‐year (p = .794) and 3‐year (p = .598) time intervals. The mean peri‐implant bone loss at 3‐year follow‐up was ?0.58 ± 0.39 mm (95% CI: ?0.751 to ?0.409) and ?0.53 ± 0.46 mm (95% CI: ?0.731 to ?0.329) for NDIs and RDIs, respectively. BoP was present at 15% and 10% of NDIs and RDIs, respectively, at 3‐year follow‐up. PPD >5 mm was observed in 5% and 0% of the implants of NDIs and RDIs, respectively, at 3‐year follow‐up. At the 3‐year examination, the implant success rates were in the NDIs and RDIs sites, respectively, 95% and 100%. The corresponding values for prosthesis success rates were 90% for NDIs and 95% for RDIs.

Conclusion

The present study demonstrated that NDIs placed to support single crowns in the posterior region did not differ to RDIs in regards to MBL, implant survival, and success rates.     

Immediate Loading of Mandibular Overdentures Supported by One‐Piece,Direct Metal Laser Sintering Mini‐Implants: A Short‐Term Prospective Clinical Study

Background: Only a few studies have dealt with immediately loaded, unsplinted mini‐implants supporting ball attachment–retained mandibular overdentures (ODs). The aim of this study is to evaluate treatment outcomes of ball attachment–retained mandibular ODs supported by one‐piece, unsplinted, immediately loaded, direct metal laser sintering (DMLS) mini‐implants. Methods: Over a 4‐year period (2009 to 2012), all patients referred to the Dental Clinic, University of Varese, and to a private practice for treatment with mandibular ODs were considered for inclusion in this study. Each patient received three or four DMLS mini‐implants. Immediately after implant placement, a mandibular OD was connected to the implants. At each annual follow‐up session, clinical and radiographic parameters were assessed, including the following outcome measures: 1) implant failures; 2) peri‐implant marginal bone loss; and 3) complications. Statistical analysis was conducted using a life‐table analysis. Results: A total of 231 one‐piece DMLS mini‐implants were inserted in 62 patients. After 4 years of loading, six implants failed, giving an overall cumulative survival rate of 96.9%. The mean distance between the implant shoulder and the first visible bone‐to‐implant contact was 0.38 ± 0.25 and 0.62 ± 0.20 mm at the 1‐ and 4‐year follow‐up examinations, respectively. An incidence of 6.0% of biologic complications was reported; prosthetic complications were more frequent (12.9%). Conclusions: Within the limits of this study, it can be concluded that the immediate loading of one‐piece, unsplinted, DMLS titanium mini‐implants by means of ball attachment–supported mandibular ODs is a successful treatment procedure. Long‐term follow‐up studies are needed to confirm these results.     

Ten‐Year Retrospective Follow‐Up Study of the TiOblast™ Dental Implant

Purpose: Long‐term results in the clinical outcome of different implant systems, including high patient numbers and a long follow‐up time, are rare. This retrospective study evaluated the cumulative survival rate of a self‐tapping, cylindrical implant system with a conical implant‐abutment connection after 10 years of prosthetic loading. Materials and Methods: A total of 516 TiOblast? implants (Astra Tech AB, Mölndal, Sweden) were placed in 108 patients. The patients were treated in the Department of Oral and Maxillofacial Surgery, Johannes Gutenberg University, Mainz, Germany, between September 1994 and May 2005. The main indications for implantation were the treatment of edentulous mandibles (74%) and partial edentulism (15%). Twenty‐three implants were placed postradiation, and a further 64 implants were irradiated after insertion. In 153 implants, a bony augmentation was conducted prior to implantation. Results: The in situ rate was 89.7% after an average implantation time of 108 months. Eighty‐three patients with 403 implants were available for investigation. Seventeen patients with 76 implants have died since 1994. Absence of osseointegration (n = 22), peri‐implantitis (n = 18), fracture of the implants (n = 9), failing of primary stability (n = 2), and implants next to tumors (n = 2) were the reasons of explantation in 26 patients. Under analysis with different implant success‐assessment criteria, the success rate showed results from 76 to 89%. Conclusion: With respect to the critical patient selection including a high number of patients with minor and major augmentations, the 10‐year clinical use of the studied implant system showed acceptable results.     

Three Tumor Patients with Total Maxillectomy Rehabilitated with Implant‐Supported Frameworks and Maxillary Obturators: A Follow‐Up Report

Background: Few reports are available on treatment using implant‐supported frameworks with maxillary obturators after total maxillectomy on tumor patients. Purpose: To describe, evaluate, and report the clinical and radiographic performance of implant‐supported frameworks and maxillary obturators after maxillectomy during the first years of function. Materials and Methods: Three patients with cancer in the maxillary region treated by total maxillectomy were rehabilitated. Seventeen dental and two craniofacial implants were installed, and the patients each received implant‐supported, screw‐retained, three‐unit frameworks with a U‐shaped bar and obturators retained by four magnetic attachments. Clinical and radiographic data were collected up to 7 years of follow‐up. Results: The frequency of complications was low. Two craniofacial implants and one dental implant were loose and removed at abutment connection. No implants were lost after framework connection, and the mean marginal bone loss was small. Conclusion: Within the limitations of this report, dental implants are useful for rehabilitation of total maxillectomy patients, and a three‐unit, screw‐retained, implant‐supported framework with maxillary obturator retained by magnetic attachment is a successful treatment concept for this patient group.     

Evaluation of Clinical Outcomes and Bone Loss around Titanium Implants with Oxidized Surface: Six‐Year Follow‐Up Results from a Prospective Case Series Study

Purpose: The aim of this prospective study was to assess long‐term clinical outcomes and peri‐implant bone level changes around oxidized implants supporting partial fixed rehabilitations. Materials and Methods: Twenty‐two partially edentulous patients were included in the study. A total of 33 fixed rehabilitations were placed, supported by 54 titanium implants with oxidized microtextured surface. Prostheses were delivered after 3 and 6 months of implant placement in the mandible and maxilla, respectively. Patients were scheduled for follow‐up at 6 and 12 months and then yearly. At each follow‐up, plaque level and bleeding scores were assessed and periapical radiographs were taken. The main outcomes were prosthesis success, implant survival, implant success, and marginal bone level change. Results: Three patients were excluded from the study because they did not attend the 1‐year follow‐up. Nineteen patients, accounting for 49 implants, were followed for at least 6 years after prosthesis delivery. The mean follow‐up duration was 81.8 months (range 75–96 months). One mandibular single‐tooth implant failed after 1 year in a smoker woman. Cumulative implant survival and success at 6 years were 98.0% and 95.9%, respectively. Prosthesis success was 96.7%. The mean peri‐implant bone loss at 6 years was 0.76 ± 0.47 mm. Not significantly (p = .75) greater bone loss was found in the maxilla (0.78 ± 0.14 mm, n = 19) as compared with the mandible (0.74 ± 0.59 mm, n = 30). In the maxilla, bone loss was significantly greater around implants supporting partial prostheses as compared with single‐tooth implants (p = .03). Full patient satisfaction was reported. Conclusion: Implants with oxidized microtextured surface may achieve excellent long‐term clinical outcomes in the rehabilitation of partial edentulism.     

Mandibular single‐implant overdentures: preliminary results of a randomised‐control trial on early loading with different implant diameters and attachment systems

Objectives: To determine surgical and prosthodontic outcomes of mandibular single‐implant overdentures, opposing complete maxillary dentures, using a wide diameter implant and large ball attachment system compared with different regular diameter implants with standard attachment systems. Materials and methods: Thirty‐six edentulous participants (mean age 68 years, SD 9.2) were randomly assigned into three treatment groups (n=12). A single implant was placed in the mandibular midline of participants to support an overdenture using a 6‐week loading protocol. The control group received Southern regular implants and standard ball attachments. One group received Southern 8‐mm‐wide implants and large ball attachments. Another group received Neoss regular implants and Locator attachments. Parametric and non‐parametric tests of a statistical software package (SPSS) were used to determine between groups differences in marginal bone loss, implant stability, implant, and prosthodontic success (P<0.05). Results: Implant success after 1 year was 75% for Southern regular implant (control) group; and 100% for the Southern wide and Neoss regular implant groups (P=0.038). Mean marginal bone loss at 1 year was 0.19 mm (SD 0.39) without significant differences observed. Implant stability quotient (ISQ) at baseline was significantly lower for the Southern regular (control) group than the other two groups (P=0.001; P=0.009). At 1 year, no significant difference in implant stability was observed (mean ISQ 74.6, SD 6.1). The change in implant stability from baseline to 1 year was significant for the control group (P=0.025). Prosthodontic success was comparable between the groups but the maintenance (41 events overall, mean 1.2) was greater for the Locator and the standard ball attachments. Conclusions: Mandibular single‐implant overdentures are a successful treatment option for older edentulous adults with early loading protocol using implants of different diameters and with different attachment systems. To cite this article:
Alsabeeha NHM, Payne AGT, De Silva RK, Thomson WM. Mandibular single‐implant overdentures: preliminary results of a randomised‐control trial on early loading with different implant diameters and attachment systems.
Clin. Oral Impl. Res. 22 , 2011; 330–337.
doi: 10.1111/j.1600‐0501.2010.02004.x     

Strategies for restoration of single implants and use of cross‐pin retained restorations by Australian prosthodontists

Background: Implant supported restorations (ISRs) for the single implant may be cement retained or screw retained. Limited scientific evidence exists to support the superiority of a retention type for either implant or prosthetic success. The aim of this study was to assess preferences of Australian prosthodontists when restoring single implants. In particular, clinical practices for cross‐pin retained implant supported restorations for a single implant were investigated. Methods: A written questionnaire comprised of seven questions, some of which had multiple parts and of both open‐ and closed‐format, was sent to 124 Australian prosthodontists. The questionnaire asked recipients to identify: (1) their preference for retention choice when restoring a single implant; (2) the frequency of use; and (3) clinical practice when restoring a cross‐pin retained restoration. Results: Seventy‐seven per cent of respondents indicated that direct to fixture (DTF) retention was their first preference. DTF retention was also the most frequently employed restoration for single implants. Respondents indicated that cross‐pinned ISRs are employed to maintain retrievability or when DTF is not possible. The majority of respondents indicated they always or sometimes use a gasket with cross‐pin retained restorations, though gasket type varied. Thirty‐eight respondents (31%) indicated that they would never use a cross‐pinned retained restoration for a single ISR. Conclusions: Australian prosthodontists prefer, and more frequently restore single implants, using DTF retention. Queensland prosthodontists prefer cement retained ISRs. In comparison, cross‐pinned restorations tend to be the least favoured and least used retention type. In addition, variation in opinion exists regarding the need for a gasket and type of gasket to be placed.     

Morse taper connection implants supporting "planned" maxillary and mandibular bar-retained overdentures: a 5-year prospective multicenter study

Objectives: In contrast to the excellent long‐term outcomes described for implant‐supported mandibular overdentures, less favorable long‐term survival and success rates have been reported for maxillary implants supporting overdentures. The aim of this study was to evaluate the treatment outcome of “planned” bar‐retained maxillary and mandibular overdentures supported by Morse taper connection implants, investigating implant survival, peri‐implant tissue health, marginal bone resorption and prosthetic complications. Material and methods: Over a 2‐year period, 60 patients were enrolled in this study, in four different clinical centers. The overdentures (maxilla 38, mandible 34) were planned with support from four implants anchored on a bar. A total of 288 Morse taper connection implants (Leone Implant System^®) were inserted (152 maxilla, 136 mandible). Implants were evaluated 5 years after insertion. Success criteria included the absence of pain, suppuration or clinical mobility, the distance between implant shoulder and first crestal bone–implant contact (DIB) <2 mm and no exudate history. Results: The overall 5‐year implant survival rate was 98% (maxilla 97.4%, mandible 98.6%), with 282 implants still in function. Among these surviving implants, 278 (98.6%) were classified in the success group. At the 5‐year examination, the mean DIB was 0.7 mm (±0.53). Few prosthetic complications were reported. Conclusions: With “planned” bar‐retained maxillary and mandibular overdentures supported by Morse taper connection implants, satisfactory survival and success rate can be achieved. To cite this article:
Mangano C, Mangano F, Shibli JA, Ricci M, Sammons R, Figliuzzi M. Morse taper connection implants supporting “planned” maxillary and mandibular bar‐retained overdentures: a 5‐year prospective multicenter study.
Clin. Oral Impl. Res. 22 , 2011; 1117–1124
doi: 10.1111/j.1600‐0501.2010.02079.x     

Early loading of implants with fixed dental prostheses in edentulous mandibles: 4.5‐year clinical results from a prospective study

Aim: The purpose of this study was to evaluate the survival and success of early‐loaded implants placed in the intraforaminal area of the edentulous mandible, and the survival of the implant‐supported fixed dental prostheses (FDP). Material and methods: Thirty‐seven patients (18.9% male, mean age 64.5 years) with edentulous lower jaws were treated with implant‐supported FDPs in the mandible. One hundred and eighty‐five screw‐type implants were placed in the intraforaminal area of the symphysis (five implants per patient). Immediately after implant placement, a framework was fabricated and the FDP was manufactured on the framework. Within 2 weeks, the implants were rigidly connected and loaded with the implant‐retained FDP. Results: During the 1–8‐year observation period (mean 4.5 years), a total of 32 implant‐retained complications occurred. Nineteen implants were lost in 10 patients, resulting in a cumulative survival of 89.7%. Nine implants in five patients did not osseointegrate. Although these implants were not removed, because stability within the connective tissue was acceptable and inflammation was absent, they were recorded as unsuccessful. Consequently, the cumulative success declined to 84.9%. Four implants in three patients had clinical signs of periimplantitis (2.2% of all implants). Denture‐related complications included one complete failure, when one FDP had to be removed after the last of five implants had been replaced. Furthermore, 10 fractures of the framework occurred in six patients, three FDPs had to be adapted or modified, and the facing of the FDP had to be repaired 16 times in 11 patients. Conclusion: Although one‐stage early‐loaded implants functioned well for most patients with edentulous mandibles, immediate loading is associated with a larger number of implant‐related complications than in other studies investigating delayed loading. Because of the substantial prosthetic complications and aftercare, this procedure cannot be generally recommended. To cite this article:
Schwarz S, Gabbert O, Hassel A J, Schmitter M, Séché C, Rammelsberg P. Early loading of implants with fixed dental prostheses in edentulous mandibles: 4.5‐year clinical results from a prospective study.
Clin. Oral Impl. Res. 21 , 2010; 284–289.
doi: 10.1111/j.1600‐0501.2009.01843.x     

Implant-supported fixed prostheses in the edentulous maxilla: 8-year prospective results

Objective: The purpose of this prospective study was to evaluate the long‐term survival and success rates of implants and screw‐retained, full‐arch prostheses placed in edentulous maxillae over 8 years of function. Materials and methods: A total of 106 Astra Tech implants were placed in the maxillae of 17 edentulous patients in a one‐stage surgical approach. After a healing period of 6 months, the patients received fixed screw‐retained bridges. Follow‐up visits, including clinical and radiographic examinations, were performed after 6 months and at yearly intervals. Implant survival, implant success, and marginal bone‐level changes were defined as the primary outcome variables. The secondary aims were to report periodontal pathogens at 5 years' follow‐up and patients' satisfaction at the 8‐year follow‐up. Results: The overall observation time was 8 years. One patient died during the study and one implant failed during the healing period, yielding an 8‐year cumulative implant survival rate of 99%. The prosthetic survival rate was 100%. The mean crestal bone loss amounted to 0.3 ± 0.72 mm. Patients' subjective evaluations demonstrated an overall high level of satisfaction. In all cases, except for one, microbiologic probing of the peri‐implant sulcus after 5 years showed no higher incidence of periodontal pathogens. Conclusions: Screw‐retained, full‐arch restorations on six implants in an edentulous maxilla are a predictable and highly successful treatment concept as observed throughout this study with an observation period of 8 years of function, in particular with respect to low crestal bone loss and high patient satisfaction. To cite this article:
Mertens C, Steveling HG. Implant‐supported fixed prostheses in the edentulous maxilla: 8‐year prospective results.
Clin. Oral Impl. Res. 22 , 2011; 464–472
doi: 10.1111/j.1600‐0501.2010.02028.x     

Resilient liner vs. clip attachment effect on peri‐implant tissues of bar‐implant‐retained mandibular overdenture: a 1‐year clinical and radiographical study

Purpose: The aim of this study was to compare between the effects of resilient liner and clip attachments of bar‐implant‐retained mandibular overdenture on peri‐implant tissues. Materials and methods: In a randomized‐controlled clinical trial, 30 edentulous male patients (mean age 62.5 years) were equally assigned to two groups. In each patient, two implants were inserted in the canine area of the mandible using a two‐stage surgical protocol. After 3 months, the implants were connected with resilient bars. Mandibular overdentures were retained to the bars with either clips (group I) or silicone‐resilient liners (group II). Peri‐implant tissues were evaluated clinically (with regard to plaque scores, gingival scores and probing depths) and radiographically (with regard to peri‐implant vertical and horizontal alveolar bone changes). Evaluations were performed at the time of overdenture insertion (T0), 6 months (T6) and 12 months (T12) after overdenture insertion. Results: After 12 months of using bar‐implant‐retained mandibular overdenture, the resilient liner attachment had significantly decreased peri‐implant plaque score, gingival score, probing depth, vertical and horizontal bone loss when compared with the clip attachment. Conclusion: Within the limitations of this study, and in terms of peri‐implant tissue health of bar‐implant‐retained mandibular overdenture, we recommend resilient liner rather than clip attachment. To cite this article:
Elsyad MA, EL Shoukouki AH. Resilient liner vs. clip attachment effect on peri‐implant tissues of bar‐implant‐retained mandibular overdenture: a 1‐year clinical and radiographical study.
Clin. Oral Impl. Res. 21 , 2010; 473–480
doi: 10.1111/j.1600‐0501.2009.01879.x     

Clinical Evaluation of Split‐Crest Technique with Ultrasonic Bone Surgery for Narrow Ridge Expansion: Status of Soft and Hard Tissues and Implant Success

Purpose: The aim of this study was to evaluate the split‐crest technique with ultrasonic bone surgery for implant placement in patients with narrow ridges, focusing on the status of soft and hard tissues and on implant success rate, at least 6 months after implant loading. Materials and Methods: During September 2007 and November 2008, 15 patients received 37 implants (BTI implants) with split‐crest surgical procedure using ultrasonic bone surgery. Plasma rich in growth factors (PRGF®) was applied during split crest procedure to promote tissue regeneration. Implant surfaces were humidified with PRGF to accelerate osseointegration. Patients were recalled for a final clinical evaluation at least 6 months after implant loading. Clinical assessment included the status of soft and hard tissues around implants, and implants' success rate. Results: Thirty‐seven implants in 15 patients were evaluated between July 2009 and January 2010. The status of soft tissues was very good, showing adequate plaque index, bleeding index, and probing depth values. Success rate of implants at the end of follow‐up (between 11 and 28 months after insertion) was 100%. Bone ridge was measured and compared at final examination showing a mean ridge expansion of 3.35 mm (SD: 0.34). Conclusions: Split‐crest with ultrasonic bone surgery can be considered an effective and safe procedure for narrow ridge expansion.     

10‐Year Survival and Success Rates of 511 Titanium Implants with a Sandblasted and Acid‐Etched Surface: A Retrospective Study in 303 Partially Edentulous Patients

Purpose: This retrospective study assessed the 10‐year outcomes of titanium implants with a sandblasted and acid‐etched (SLA) surface in a large cohort of partially edentulous patients. Materials and Methods: Records of patients treated with SLA implants between May 1997 and January 2001 were screened. Eligible patients were contacted and invited to undergo a clinical and radiologic examination. Each implant was classified according to strict success criteria. Results: Three hundred three patients with 511 SLA implants were available for the examination. The mean age of the patients at implant surgery was 48 years. Over the 10‐year period, no implant fracture was noted, whereas six implants (1.2%) were lost. Two implants (0.4%) showed signs of suppuration at the 10‐year examination, whereas seven implants had a history of peri‐implantitis (1.4%) during the 10‐year period, but presented with healthy peri‐implant soft tissues at examination. The remaining 496 implants fulfilled the success criteria. The mean Plaque Index was 0.65 (±0.64), the mean Sulcus Bleeding Index 1.32 (±0.57), the mean Probing Depth 3.27 mm (±1.06), and the mean distance from the implant shoulder to the mucosal margin value ?0.42 mm (±1.27). The radiologic mean distance from the implant shoulder to the first bone‐to‐implant contact was 3.32 mm (±0.73). Conclusion: The present retrospective analysis resulted in a 10‐year implant survival rate of 98.8% and a success rate of 97.0%. In addition, the prevalence of peri‐implantitis in this large cohort of orally healthy patients was low with 1.8% during the 10‐year period.     

Dental Implants in Patients with Oral Lichen Planus: A Cross‐Sectional Study

Purpose: The main aim of this study was to evaluate the patients with oral lichen planus (OLP) and dental implants. Material and Methods: Three groups of 16 patients took part in the study. Group I patients had received dental implants and been diagnosed with OLP; Group II had not received implants but were diagnosed with OLP; Group III had implants but not OLP. Clinical observations and OLP symptoms were registered in each case. Periodontal pocket depth, implant mobility, bleeding upon probing, erythema, pain, and radiolucency around implants were measured. Patient quality of life was evaluated using OHIP 14. Results: Peri‐implant mucositis and peri‐implantitis were detected in 17.86% and 25% of the OLP‐implant group, while the control group with implants showed 18% and 16%. The implant survival rate in patients treated for OLP did not appear to differ from the survival rate among the general population. Quality of life was better among patients with implants and without OLP (p = .001). Conclusions: The results of the present study suggest that implants do not influence manifestations of OLP. OLP is not a risk factor for peri‐implantitis.     

Implant Abutment Cleaning by Plasma of Argon: 5‐Year Follow‐Up of a Randomized Controlled Trial

Background: Contamination of implant abutments could potentially influence the peri‐implant tissue inflammatory response. The aim of the present study is to assess the radiographic bone changes around customized, platform‐switched abutments placed according to the “one‐abutment‐one‐time” protocol, with and without plasma of argon cleaning treatment. Methods: Thirty healthy patients with thin gingival biotype (<1 mm) and history of periodontal disease received one maxillary implant each. Immediately before abutment connection, patients were randomly assigned to control group (cleaning protocol by steaming) or test group (plasma of argon treatment). Outcome measures were: 1) success rate of implants and prostheses; 2) biologic and prosthetic complications; 3) peri‐implant marginal bone loss (MBL); 4) esthetic and periodontal parameters; and 5) patient satisfaction. Results: Neither implants nor prostheses were lost in either group at the 5‐year follow‐up examination. Overall, both groups showed a slight amount of peri‐implant bone loss from baseline to 5 years. A statistically higher mean MBL was found in the control group compared with the test group at 6, 24, and 60 months after crown connection. Nevertheless, during the entire follow‐up period, intragroup comparison demonstrated statistically significant mean MBL in the control group, but not in the test group. The test group showed a higher mean gain at the soft tissue margin, but not for the papilla. All implants showed good periodontal parameters, with no significant differences between groups. Conclusion: Plasma of argon could be used to disinfect implant abutments before insertion to minimize future peri‐implant bone resorption.     

Implant-retained mandibular overdentures with immediate loading: a 3- to 8-year prospective study on 328 implants

Purpose: The purpose of this study is to evaluate prospectively survival and success rates of implants placed in the inter‐foraminal area of edentulous mandibles and immediately loaded with an implant‐supported overdenture. Materials and Methods: Eighty‐two patients, 33 males and 49 females, aged between 42 and 87 years (mean age 58.6 yr), presenting edentulous mandibles were rehabilitated with an implant‐supported overdenture in the mandible. Three hundred twenty‐eight screw‐type osseointegrated implants (164 Ha‐Ti, Mathys Dental, Bettlach, Switzerland; 84 ITI Dental Implant System, Straumann Institute, Waldenburg, Switzerland; 40 Brånemark Conical, Nobel Biocare AB, Gothenburg, Sweden; 40 Frialoc, Friatec, AG Mannheiti, Germany), were placed in the intraforaminal area of the mental symphysis (4 implants per patient). Immediately after implant placement, a U‐shaped gold or titanium bar was fabricated and implants were rigidly connected with the bar and immediately loaded with an implant‐retained overdenture. Success rate of implants was evaluated clinically and radiographically every year after the loading of the prostheses according to the following parameters: (1) absence of clinical mobility of implants tested individually after bar removal, (2) absence of periimplant radiolucency evaluated on panoramic radiographs, (3) absence of pain and radiologic or clinical signs of neural lesion, and (4) peri‐implant bone resorption mesial and distal to each implant less than 0.2 mm after the first year of prosthetic load. Results: Of 328 implants placed, 296 were followed up from a minimum of 36 months to a maximum of 96 months, with a mean follow‐up of 62 months. Seven implants in 6 different patients were removed owing to loss of osseointegration, whereas 18 implants, although still osseointegrated, did not fulfill success criteria due to bone resorption > 0.2 mm/year after the first year of loading. Despite implant losses, all patients maintained their bars supporting overdentures, although in 6 patients they were supported by 3 instead of 4 implants. The only patient who lost 2 implants received 2 new implants, which survived normally. Therefore, the absolute success and survival rates were 91.6% and 97.6%, respectively, whereas the cumulative survival and success rates of implants obtained with a life table analysis were 96.1% and 88.2%, respectively. Conclusions: Results of this study seem to demonstrate that survival and success rates of immediately loaded implants placed in the intraforaminal area of the mandible and rigidly connected with a bar through an implant‐supported over‐denture are consistent with those reported in the international literature as far as delayed loading is concerned after 3 years of loading. After longer observation times, this study demonstrated that, while survival rates of implants and bar‐supported overdentures are still consistent with results published in the international literature pertaining to delayed loading, a moderate decrease in success rates of implants was found. Nevertheless, it must be stressed that this decrease (88.8 and 90.4% after a 7‐ to 8‐year observation period for Ha‐Ti and ITI implants) is related only to two implant systems; no data are available for the other two implant systems because of the shorter follow‐up period.     

Immediate functional loading of TiOblast dental implants in full‐arch edentulous maxillae: a 3‐year prospective study

Introduction: Immediate functional loading of dental implants for full‐arch restoration is a patient‐friendly approach, shown to be feasible with a good long‐term prognosis in a completely edentulous mandible. For the complete restoration of the maxilla, acceptable long‐term clinical follow‐up is lacking or based on case reports rather than on prospective studies. Objectives: This prospective mono‐centre study reports the 3‐year outcome of immediately functionally loaded Astra Tech Dental implants in completely edentulous maxillae based on clinical survival and success based on radiographical assessment of bone level. Material and methods: One hundred and ninety‐five Astra Tech TiOblast surface fixtures were installed in 25 consecutively treated patients (age range: 42–76 years), of whom eight were smokers, 12 had a confirmed history of periodontitis and six had poor bone quality normally deemed for delayed loading. Fixtures and abutments were inserted in a one‐stage procedure and functionally loaded within 24 h with a 10‐unit provisional glass‐fibre or metal‐reinforced screw‐retained restoration. After 6 months, each implant was checked for stability using a manual torque of 20 N cm and the provisional restoration was replaced by a 10–12‐unit screw‐retained metal–ceramic or metal–resin cantilever bridge. Bone level was assessed radiographically from the day of surgery up to 3 years and used to calculate mean bone loss at the patient level and individual implant success. Results: No failures occurred in implants or prostheses, the total survival rate being 100%. Mean marginal bone loss was 0.58 mm (SD 0.58); 0.6 mm (SD 0.53); 0.63 (SD 0.61); and 0.72 (SD 0.63) after 6 and 12 months, and 2 and 3 years, respectively, yielding a 100% success at the patient level. Wilcoxon's signed ranks test showed only statistically significant bone loss between baseline and 6 months and a steady‐state condition during all other intervals. At the individual fixture level, 82% lost <1 mm marginal bone between baseline and 1 year. After 3 years, 86% have <1.5 mm total bone loss and can be considered a success. The fixtures expressing more bone loss were all inserted in smokers. Conclusion: Immediate loading of a full‐arch maxillary bridgework on 7–9 Astra Tech TiOblast implants is a predictable treatment option with 100% fixture survival and stable bone‐to‐implant contact up to 3 years. The steady state in bone remodelling is indicative of a good long‐term prognosis in non‐smokers but smokers seem to be more prone to bone loss.